Top Mississippi lawmakers are negotiating a landmark plan to expand Medicaid coverage to tens of thousands of people in one of the poorest states in the U.S. While Republicans control both the state House and Senate, it is uncertain if they will reach a compromise during the final days of their four-month session scheduled to end by early May. Mississippi is one of the 10 states that have not expanded Medicaid coverage to low-wage workers. Expansion is an option under the federal health care overhaul signed into law in 2010.

Republican Gov. Tate Reeves has opposed putting more people on government programs for years, but expansion is under discussion in the Mississippi Capitol this year as it is a priority for the new House speaker, Republican Jason White. The House voted in late February to expand Medicaid coverage to about 200,000 people who earn up to 138% of the federal poverty level, while the Senate passed its own version that would extend eligibility to people earning up to 100% of the federal poverty level. House Medicaid Committee Chairwoman Missy McGee offered a compromise to allow Mississippi to receive the full amount of federal money possible for expansion.

Senators have not responded to the House’s proposal and have not offered any new proposals. Senate Medicaid Committee Chairman Kevin Blackwell stated that about 80,000 people would become eligible for coverage under the Senate’s proposal, but he believed only about half that number would enroll. While the two chambers are discussing expansion, Blackwell cautioned against moving too fast, advocating for a slower approach. McGee believes that Mississippi has been waiting too long and should not delay the expansion of Medicaid any further for low-income individuals in the state.

Mississippi legislators usually meet in private to negotiate bills, but this year they agreed to hold open meetings on Medicaid expansion. The meeting on Tuesday was standing-room only, with some spectators arriving hours early. While discussions are ongoing, it is unclear if a compromise will be reached before the end of the session. The potential expansion of Medicaid in Mississippi could provide health coverage to a significant number of low-wage workers in the state, but the political landscape and differing proposals from the House and Senate may pose challenges to achieving this goal.

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